Successful Laparoscopic Hysterectomy with Myomectomy, Salpingectomy, Ureteroscopy for Multiple Uterine Fibroids in a 46-Y.O. Woman
PACE Hospitals’ Expert Gynaecology team successfully performed a Laparoscopic Hysterectomy with broad ligament Myomectomy, Bilateral Salpingectomy, and Ureteroscopy on a 46-year-old female patient diagnosed with multiple uterine fibroids, including a broad ligament fibroid. She had presented with abnormal uterine bleeding and anemia.
Uterine fibroids are one of the most common non-cancerous tumors affecting women of reproductive age. While many fibroids can be managed with medications and minimally invasive options, some cases require major surgical intervention when the fibroids are large, multiple, or causing severe symptoms.
PACE Hospitals is one of the Best Gynecology Hospital in Hyderabad, Telangana, India, providing comprehensive patient-centric treatment for all gynaecological diseases and disorders. The team of experienced and skilled gynaecologist, obstetrician and gynaecology surgeons have wide expertise in managing all types of common and critical women’s health conditions
☑️ Past Medical History
The patient’s obstetric history was P1L1, indicating one full-term delivery with one living child. She had no known comorbidities.
☑️ On Examination
On general examination, the patient was conscious, coherent, and cooperative. Vital signs were within normal limits. Systemic examination revealed normal air entry on respiratory assessment and normal heart sounds (S1 and S2) on cardiovascular examination. Per abdominal examination showed a soft, non-tender abdomen. Breast examination was normal, with no lumps detected. On per speculum and per vaginum examination, the cervix and vagina appeared healthy.
☑️ Diagnosis
Upon admission to PACE Hospitals, the patient was evaluated by the Gynaecology team, with a detailed history and clinical examination suggesting a bulky uterus with multiple fibroids, including a broad ligament fibroid. She presented with menorrhagia and prolonged cycles unresponsive to medical management, along with recurrent anemia due to chronic blood loss.
Ultrasound confirmed multiple fibroids, and preoperative investigations revealed mild anemia with microcytic hypochromic RBCs and neutrophilic leukocytosis. Renal function and electrolytes were within normal limits.
Based on these findings, the patient was advised to undergo Uterine Fibroid Treatment in Hyderabad, India, under the expert care of the Gynaecology Department, ensuring comprehensive evaluation and management tailored to the patient’s needs.
☑️ Medical Decision Making
After a detailed consultation with Dr. Mugdha Bandawar, Obstetrician, Gynecologist, in collaboration with Urologist consultant Dr. K. Ravichandra, a multidisciplinary approach was taken to determine the most appropriate diagnostic and therapeutic strategy for the patient. Considering her history of previous normal vaginal delivery (P1L1), alongside the clinical findings of a bulky uterus and ultrasound evidence of multiple fibroids, including a broad ligament fibroid, the team assessed the extent of the pathology and potential complications, particularly the proximity of the fibroid to the ureter.
Further evaluation, including physical examination and laboratory investigations, confirmed the need for surgical intervention. It was determined that Laparoscopic Hysterectomy with Broad Ligament Myomectomy, Bilateral Salpingectomy, and Ureteroscopy was identified as the most effective surgical approach to relieve symptoms, control anemia, and prevent further gynecological or urological complications.
The patient and her family members were counselled regarding the diagnosis, the planned procedure, associated risks, expected benefits, and the potential for significant improvement in quality of life, after which informed consent was obtained.
☑️ Surgical Procedure
Following the decision, the patient was scheduled to undergo Laparoscopic Hysterectomy Surgery in Hyderabad at PACE Hospitals along with broad ligament myomectomy with bilateral salpingectomy with ureteroscopy under the supervision of the expert Gynaecology Department.
The following steps were carried out during the procedure:
Preoperative Preparation and Diagnostic Laparoscopy: Under general anesthesia, pneumoperitoneum was established, and laparoscopic ports were placed. Initial laparoscopy revealed a bulky uterus with multiple fibroids, including a 3x3 cm fibroid in the left broad ligament. Bilateral tubes and ovaries appeared normal.
Ureteroscopy and Ureteric Catheterization: Due to the proximity of the broad ligament fibroid to the left ureter, ureteroscopy was performed and a ureteric catheter was placed to identify and protect the ureter during surgery.
Broad Ligament Myomectomy: The broad ligament was carefully dissected, and the 3x3 cm fibroid was enucleated without complications. Hemostasis was secured with bipolar cautery.
Laparoscopic Hysterectomy with Bilateral Salpingectomy: The uterus with cervix and bilateral fallopian tubes was removed laparoscopically. Uterine vessels and ligaments were safely coagulated and transected. The specimen was sent for histopathology.
Final Inspection and Closure: The pelvis was irrigated and checked for bleeding. The ureteric catheter was retained. After confirming hemostasis, instruments were removed, and port sites were closed.
Why Choose PACE Hospitals for Laparoscopic Hysterectomy with Myomectomy, Salpingectomy, and Ureteroscopy for Multiple Uterine Fibroids?
Choosing the right hospital for advanced gynecological surgery is crucial. PACE Hospitals has built a strong reputation for delivering high-quality surgical care, especially in minimally invasive laparoscopic procedures. Here are the reasons patients prefer PACE Hospitals:
✔️ Expert Gynecologists & Laparoscopic Surgeons
Highly experienced specialists in complex gynecological laparoscopic surgeries.
Expertise in treating multiple uterine fibroids with myomectomy (fibroid removal), hysterectomy (uterus removal), and salpingectomy (fallopian tube removal), often in the same sitting.
✔️ Advanced Minimally Invasive Techniques
State-of-the-art laparoscopic and endoscopic equipment.
Small incisions, minimal blood loss, faster recovery, and less post-operative pain compared to open surgery.
Specialized ureteroscopy care to protect urinary structures during surgery.
✔️ Comprehensive Women’s Health Care
PACE offers a multidisciplinary approach, involving gynecologists, anesthetists, radiologists, and urologists.
Safe management of associated problems like urinary tract involvement, recurrent fibroids, or endometriosis.
✔️ High Success Rate & Safety Protocols
Proven track record in complex hysterectomy procedures.
Stringent infection control and enhanced surgical safety protocols.
Well-equipped ICUs and emergency care units available on-site.
✔️ Patient-Centric Care
Individualized surgical plans depending on the patient’s age, fertility goals, and overall health.
Pre-operative counseling, transparent procedures, and compassionate support.
Special focus on fertility-preserving surgeries when required.
✔️ Rapid Post-Operative Recovery
Early mobilization and same/next-day discharge for most patients.
Reduced hospital stay and faster return to normal life.
Dedicated physiotherapy and post-surgical rehabilitation support.
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